Does ultrasound guidance improve the outcomes of arthrocentesis and corticosteroid injection of the knee?
Scand J Rheumatol
; 41(1): 66-72, 2012 Feb.
Article
em En
| MEDLINE
| ID: mdl-22103390
ABSTRACT
OBJECTIVE:
The present randomized controlled trial compared arthrocentesis of the effusive knee followed by corticosteroid injection performed by the conventional anatomic landmark palpation-guided technique to the same procedure performed with ultrasound (US) needle guidance.METHODS:
Sixty-four palpably effusive knees were randomized to (i) palpation-guided arthrocentesis with a conventional 20-mL syringe (22 knees), (ii) US-guided arthrocentesis with a 25-mL reciprocating procedure device (RPD) mechanical aspirating syringe (22 knees), or (iii) US-guided arthrocentesis with a 60-mL automatic aspirating syringe (20 knees). The one-needle two-syringe technique was used. Outcome measures included patient pain by the Visual Analogue Scale (VAS) for pain (0-10 cm), the proportion of diagnostic samples, synovial fluid volume yield, complications, and therapeutic outcome at 2 weeks.RESULTS:
Sonographic guidance resulted in 48% less procedural pan (VAS; palpation-guided 5.8 ± 3.0 cm, US-guided 3.0 ± 2.8 cm, p < 0.001), 183% increased aspirated synovial fluid volumes (palpation-guided 12 ± 10 mL, US-guided 34 ± 25 mL, p < 0.0001), and improved outcomes at 2 weeks (VAS; palpation-guided 2.8 ± 2.4 cm, US-guided 1.5 ± 1.9 cm, p = 0.034). Outcomes of sonographic guidance with the mechanical syringe and automatic syringe were comparable in all outcome measures.CONCLUSIONS:
US-guided arthrocentesis and injection of the knee are superior to anatomic landmark palpation-guided arthrocentesis, resulting in significantly less procedural pain, improved arthrocentesis success, greater synovial fluid yield, more complete joint decompression, and improved clinical outcomes.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Osteoartrite
/
Palpação
/
Artrite Reumatoide
/
Corticosteroides
/
Ultrassonografia de Intervenção
/
Paracentese
/
Articulação do Joelho
Tipo de estudo:
Clinical_trials
/
Guideline
Limite:
Humans
Idioma:
En
Revista:
Scand J Rheumatol
Ano de publicação:
2012
Tipo de documento:
Article
País de afiliação:
Estados Unidos